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ADA 2020: Practice-changing updates from trials in T2D & GDM

M3 India Newsdesk Jul 06, 2020

The American Diabetes Association (ADA) took its 80th Scientific Sessions of 2020 online, calling it their first-ever Virtual Experience. ADA claims to have created a record of sorts with an enrolment of over 12,500 participants from around the world and 800+ presentations on a myriad of topics concerning diabetes. Here we give you a lowdown on some important presentations made during the sessions.

DAPA-HF: Exploring the effect of Dapagliflozin on the Incidence of Diabetes

Dapa reduced new-onset diabetes by 32% in 55% patients without diabetes. It could very well help in diabetes prevention.

Having seen the positive results Dapagliflozin gave for HF [(brought worsening heart failure (HF) under control, reduced its related mortality and ejection fraction (HFrEF) among the 45% patients who had baseline Type 2 Diabetes (T2D)], researchers examined its effect on the onset of diabetes in non-T2D patients.

Inzucchi SE, et al. used a Cox proportional hazards model for evaluation and a Fine and Gray competing risk model for verification and accounting for mortality. Their study provided the following results:

  • There were 2605 non-T2D patients at baseline. Of these, 157 developed T2D on trial and 150 had prediabetes
  • Patients with incident T2D presented a higher mean baseline, greater BMI, and lower eGFR in comparison to the non-diabetic patients
  • Dapa was successful in reducing new-onset diabetes by 32% when assessed using the Cox model and the results were almost similar when verified with the Fine and Gray model

Read the abstract here.

EMPA-REG Trial Finding: Empagliflozin delays need for insulin in T2D patients with CVD

Empagliflozin (EMPA) reduced the need for insulin by 54% in 52% of insulin-naïve patients and by 57% for 48% of patients who used insulin at baseline and needed a >20% increase in insulin dosage.

The EMPA-REG Trial Outcome brought the news of reduced insulin needs for patients with Type 2 Diabetes (T2D) and Cardiovascular Disease (CVD) yet to be initiated on insulin and even those who may have needed an increase in its dosage. Presented by Vaduganathan M, et al., the study was conducted on 7020 patients, all of whom were put on EMPA 10 mg, 25 mg, or placebo. The observations were as under:

  • EMPA reduced the need for insulin in 52% (3633) insulin-naive patients vs. PBO by 54%
  • EMPA was also successful in reducing the need for a >20% increase in the insulin dosage by 57% for 48% (3387) patients using insulin at baseline
  • The finding also showed that the reduction in insulin use was remarkable in T2D patients within five years of diagnosis when compared to those who had T2D for more than 5 to 10 years or more than 10 years

Read the abstract here.

VERTIS-CV- CVOT Trials: Ertugliflozin shows consistent benefits for HF

Ertugliflozin shows about a 1/3rd reduction in hospitalisation due to heart failure (HF), which is statistically significant in comparison to placebo.

Dr. Cannon CP recently presented a trial for Ertugliflozin, VERTIS-CV at the virtual annual scientific sessions of ADA. He highlighted that the primary endpoint of the trial was its non-inferiority to placebo when prescribed alongside a standard T2D medication to achieve the combined endpoint of cardiovascular death, non-fatal myocardial infarction (MI), or non-fatal stroke. The important aspects of results are as under:

  • Ertugliflozin 5 mg and 15 mg both met the endpoint, came very close to the placebo rate and proved to be non-inferior; however, there was no indication of its superiority to placebo
  • Other results of the trial showed consistency with those of the previously conducted studies and did not demonstrate any increase in total adverse events or serious adverse events

Read the abstract here.

GDM: Pre-pregnancy plant-based diet can possibly lower risk

A cohort of 15,999 women that was studied showed that pre-pregnancy BMI influenced the link between overall plant-based diet index (PDI) and Gestational Diabetes Mellitus (GDM) by 61.3% and between healthful plant-based diet index (hPDI) and GDM by 44.4%.

Researchers and authors Chen Z, Qian F, Liu G, Li M, Voortman T, Ley SH, et al. conducted a study to identify if a plant-based diet could contribute to lowering the risk of GDM. A group of 15,999 women with at least one singleton pregnancy over a decade was chosen and 891 cases of GDM were documented during follow-ups. The observations were as under:

  • Both PDI and hPDI were significantly and inversely associated with GDM
  • As per the estimation of researchers, pre-pregnancy BMI played a role in the connection between PDI and GDM and it was scored at 61.3%
  • Likewise, hPDI and GDM too were influenced by pre-pregnancy BMI by about 44.4%

No remarkable links were found between unhealthful plant-based diet index (uPDI) and GDM.

Read the abstract here.

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